Obsessive–compulsive disorder: treatment and treatment resistance

  1. Sean Hood1,
  2. Deirdre Alderton2,
  3. David Castle3

Article first published online: 12 JAN 2002

DOI: 10.1046/j.1440-1665.2001.00316.x

Issue

Australasian Psychiatry

Australasian Psychiatry

Volume 9, Issue 2, pages 118–127, June 2001

Additional Information

How to Cite

Hood, S., Alderton, D. and Castle, D. (2001), Obsessive–compulsive disorder: treatment and treatment resistance. Australasian Psychiatry, 9: 118–127. doi: 10.1046/j.1440-1665.2001.00316.x

Author Information

  1. 1

    Alma Street Centre, Fremantle Hospital and Health Service & Clinical Research Fellow, Psychopharmacology Unit, University of Bristol, England.

  2. 2

    Alma Street Centre, Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia.

  3. 3

    University of Western Australia & Clinical Director, Alma Street Centre, Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia.

* Correspondence: Sean Hood, Alma Street Centre, Fremantle Hospital and Health Service Perth, WA 6160. Email: sean.hood@bristol.ac.uk

Publication History

  1. Issue published online: 12 JAN 2002
  2. Article first published online: 12 JAN 2002

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Keywords:

  • obsessive–compulsive disorder;
  • treatment;
  • treatment resistance

Objective: To review the treatment options for obsessive–compulsive disorder (OCD), with particular reference to treatment resistance, and provide a guideline for clinicians managing these patients, drawing upon evidence from clinical trials and expert consensus.

Conclusions: The behavioural technique of exposure and ritual prevention (EX/RP) and serotonergic medications have emerged as effective standard treatments of OCD, although full symptom remission is rare. Predictors of poor and partial response to these treatments may reflect substantial underlying heterogeneity in OCD. Clinicians can now begin to apply psychological and pharmacological augmenting strategies that specifically target these heterogenous subgroups in an attempt to improve response. We offer a treatment algorithm for OCD derived from this understanding.

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